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Monday, February 23, 2009

In West Palm Beach

I've just returned from Florida where I completed the second of three courses leading to a certificate in canine rehabilitation therapy (see previous post on canine rehab). Canine rehabilitation uses different modalities (like ultrasound, laser, stretching, manipulations, and various exercises) to physically rehabilitate dogs with various musculoskeletal disorders, those recovering from surgery, obese animals, or to increase performance in working dogs. The course was taught by a spectacularly entertaining instructor: Laurie Edge-Hughes, a physiotherapist (physical therapist for those in the US), certified in canine rehab, with a Master's degree in animal science from the University of Queensland, Australia. She runs a successful rehab practice in Calgary, Alberta.

Most of what we learned was fundamental to recognizing and diagnosing musculoskeletal, neurological, and joint disorders in dogs. However, we barely touched on these concepts in veterinary school, at least not ten years ago.

With renewed passion, I launch myself into this relatively new and exciting field.

Not using it to its full potential but a start nonetheless...

Saturday, February 14, 2009

Killing stray dogs

What is there to do when dogs attack civilians in a country without adequate resources? Police and veterinarians are killing stray dogs in Baghdad as there are too many strays to save and many are extremely aggressive towards people, often attacking them.
There is no mention in the CNN article of the SPCA International proposing how veterinarians in Baghdad would implement mobile spay and neuter clinics. Perhaps they can propose and pay for novel and painless ways to have some of these dogs euthanized instead of having them shot. Since these dogs are not dying instantly, they must be experiencing some moments of pain and sheer terror. I think using tranquilizer guns would be the least traumatic and painless for these dogs. Once tranquilized, the dogs can easily, safely, and painlessly, be euthanized. How much more would tranquilizer guns cost than shotguns?

The lives of people trump those of feral, aggressive dogs, but the manner in which this cull is being executed is completely unacceptable.

Appropriate tool to perform euthanasia?

Thursday, February 12, 2009

This'll make you laugh

I would like to subject you to a video that made me laugh out loud. As you will see, cats are not the perfect, poised, calm acrobats we think they are.

Wednesday, February 11, 2009

Euthanasia: at home or at the vet hospital?

If I were not a vet, I would only trust a veterinarian I know well to euthanize my pet. I would not call upon somebody I didn't know to perform such an intimate, solemn, and heart-wrenching procedure. Where would you have this done? What if you didn't know a veterinarian very well?

Monday, February 9, 2009

"Don't talk to the animals," says autistic professor

Here I'll lazily direct you to an article published in the Globe and Mail. A must read.

Her basic tenet is this:

What she really wants us to do, if we're at all interested in providing animals with a decent life, is to approach them more on their terms than on ours - to see and feel the world completely as they do.

As I maintain in many of my posts, we need to stop treating our pets, livestock, and all animals, as humans beings.

Click here to read the article.


Professor Temple Grandin
Listen to an interview with her on NPR here.

Sunday, February 8, 2009

FYI



is less closely related to this



than this is



to



Now guess the breeds... Ok, here's a hint, but apparently there's some debate as to the breed depicted here - confused?

Saturday, February 7, 2009

Both the vet and the client

Soon before I left NYC, my cat's diabetes became quite uncontrolled. His previously controlled blood glucose became consistently high, and could not be regulated, even with increasing doses of insulin. This is called insulin-resistance. While he didn't have "text-book" insulin resistance, I knew something was awry.
Diabetic cats' insulin requirements can dramatically increase when they have a concurrent illness. Things to rule out are: urinary tract infections (including pyelonephritis), chronic pancreatitis, hyperadrenocorticism (Cushing's), acromegaly (increased production of growth hormone), dental disease, heart disease, and different types of cancer.
So I brought him to the hospital where I was working, performed full-body radiographs: normal. Full CBC, chemistry, T4, urine cortisol-creatinine ratio, feline PLi, urinalysis, and urine culture - all perfectly normal. Hmm....
There was not a clue as to what was going on. While a little frustrated, I knew there was a strong possibility there was still something wrong with Isaac. When I returned to Toronto, I scheduled an ultrasound for him. The ultrasound showed mildly enlarged kidneys, consistent with pyelonephritis (I've already posted twice on this disease). Interestingly, and frustratingly, his previous urinalysis was completely normal - crystal clear - and his culture was negative; not a hint of an infection.
With chronic disease, though, this is still possible and therefore not a complete mystery.
I started Isaac on a 6-8 week course of antibiotics and so far, he's doing great.

Had I not performed the ultrasound, he would likely have deteriorated.

What are the lessons here? 1) To understand that tests are not always diagnostic - of course they can be - and that normal test results do not necessarily ruled out everything.
2) In many cases, further work-ups are necessary. After preliminary tests, this often (but not always) means imaging, such as x-radiography, ultrasound, MRI (magnetic resonance imaging) or CT (computed tomography).
3) Sometimes, even specialists (in medicine, too!), cannot achieve diagnoses - there are true mystery illnesses.
4) Follow your suspicions: in this case, there was some, but not overwhelming, evidence that Isaac was sick. I was most probably right.

Isaac's diagnosis of pyelonephritis is strongly suspected, but is still not confirmed. I am now both the client and the veterinarian, and will just have to be patient for now....


Will Isaac have to go back?

Tuesday, February 3, 2009

Something I didn't learn in vet school

In vet school, I was taught extensive anatomy, physiology, histology, pathology, and medicine in dogs, cats, ruminants, birds, and equines. I learned how to auscultate the heart, lungs, and digestive tract of all of these species. I learned how to treat IMHA, GDV, colic, conjunctivitis, Addison's disease, VPCs, and the ABCs of resuscitation. I learned how to make radiographic diagnoses, when to vaccinate animals, how to spay a cat, and how to remove a portion of a cat's small intestine.

What I was not taught was how to deal with career exhaustion, burnout, and compassion fatigue.

I blissfully entered the field sporting an invisible cape and hero suit on which "Super Vet" was emblazoned - at least that is who I wanted to be. Lo and behold I am not the superhero veterinarian I thought I was, but rather one who has come to question his future.

There are alarming statistics regarding career burnout in veterinarians. Vets are four times more likely than the general population to commit suicide. This is truly shocking. Please read the entire article here (I think the author went a little nuts about veterinarians' abuse of the drug ketamine, but I digress).
Why is this? Vets are typically happy-go-lucky people who have "the best job in the world," right? As pets become ever-increasing members of the family, the quality of their health and care must increase in tandem. This puts increasing pressure on veterinarians to perform, to heal, and to cure, added pressures to an exceedingly-high pressure profession.
Attesting to this fact, many vets are perfectionists, therefore a lack of "success" in treating veterinary patients and medical errors can lead to feelings of utter failure, lack of self-esteem, and eventual depression.

I was not taught that I would have to deal with eccentric and overly-demanding pet owners. I was not taught how to deal with the stress associated with such pet owners, difficult-to-manage cases, a physically demanding job, euthanasia, and grieving clients. I had to do this on my own. Self-taught, I believe I was only partly successful. I do, luckily, have other "teachers" to get me through this...
Given the statistics regarding occupational (mental) health in veterinarians, it is incumbent on veterinary schools everywhere in the world to sensitize veterinary students and prospective veterinary students to the many stress-related issues facing veterinarians today, these issues unfortunately eschewed by veterinary institutions.

I want to finally accept my limitations as a veterinarian, and as a human being so that my feelings of ineptitude and guilt can finally be extirpated from my being.

Monday, February 2, 2009

A documentary the world needs to watch.

While this doesn't pertain to veterinary medicine per se, it is something that has provided me with more food-for-thought than virtually anything else I have seen or read. Ever.
Here's a documentary that examines a chilling scenario. Chilling for us, perhaps. Stunning for the planet and, save us, all of its inhabitants.
The documentary is based on the international bestseller,"The World Without Us," by Alan Weisman.
I wonder if the planet will ever again thrive in our presence.